Learn / What to Do When Someone You Love Is Suicidal
Immediate help is available. If you or someone in your life is experiencing suicidal thoughts, you can call the National Suicide Prevention Lifeline at 1-800-273-8255.
Suicidal ideation, or suicidality, is the act of wanting or expressing that you want to commit suicide. If someone you love shows these symptoms, they should be taken very seriously. Fortunately, there are ways that you can help. Some rehab programs offer treatment for suicidal ideation.
Suicide is a global health concern.1 In 2019, it caused more than 1 in every 100 deaths worldwide. And 47,511 people died of suicide in the U.S.2 in the same year, making it the nation’s 10th leading cause of death. Suicidal tendencies may be caused by chronic mental health conditions, adverse life experiences, or a history of trauma. Whatever a person’s circumstances, it’s important to believe them if they express an interest in suicide.
If you’re concerned that a loved one is at risk, there are many ways you can take action. In this event, it’s important to be aware of your own capabilities. No matter how much you care about someone, you may not be able to keep them safe without professional help. But you can absolutely connect them with the resources they need. In order to get them the best possible care, you should first learn to recognize the signs and symptoms of suicidality.
Suicidal ideation may be a symptom of a number of mental health concerns, including but not limited to depression, schizophrenia, and bipolar disorder. It can also appear in the absence of any other diagnosis. People who have recently experienced a great loss—such as the death of a loved one, the end of a partnership or a job, or another major life change—may be at risk.
Not every mention of suicide is a sign of imminent danger.3 If your loved one has major depression, talking about their fears may be a call for help, or a sign that they trust you enough to share their innermost feelings. Pay close attention to the context of the conversation, and the specific details they share, in order to assess how urgent the situation is. A person at immediate risk of suicide definitely requires emergency care. On the other hand, a person who is casually thinking about suicide with no plans to act on those thoughts may benefit more from therapy and increased social support.
However you respond, it’s important to take any suicidal thoughts very seriously. Begin by reaching out to experts who can help. You can always start by calling or texting a suicide hotline, such as the National Suicide Prevention Lifeline, the Crisis Textline, or the Trans Lifeline, which specifically supports transgender clients. In addition, there are some specific warning signs you can look for when you’re concerned that a loved one may be considering suicide.
People with suicidal ideation may or may not tell you exactly what’s on their mind. Of course, frequent discussions of the topic are in and of themselves warning signs of suicide.4 However, the signs aren’t always that straightforward. They may also talk about feeling hopeless, trapped, or “like a burden.” Any of these subjects may indicate suicidality, especially if they come up on a regular basis.
If a person trusts you enough to tell you how they’re feeling, it’s important to respond with kindness and compassion. Consciously or not, this may be their way of asking for help. Understand that you can’t “fix” the problem for them, but you can guide them toward professional help.
You can help prevent suicide5 by simply noticing if and how a loved one’s habits change. Suicidal ideation can cause people to lose interest in activities they used to enjoy. If you notice that a person you care about has stopped engaging in their favorite hobbies, talking to their closest friends, or taking pride in their work, it may be a sign of poor mental health.
However, this alone is not necessarily a cause for concern. People grow, and their interests may change over time. Specifically, a person who pulls back from beloved activities in order to spend more time idle and alone may be at risk.
If a person starts to withdraw from social plans they once enjoyed, or puts significant distance between themselves and their closest loved ones, they may be exhibiting warning signs. Many of those with suicidal ideation worry that their poor mental health is hurting those around them, and withdraw from relationships in order to lessen that perceived burden. However, this increased isolation may just exacerbate their symptoms.
It may seem counterintuitive, but a seemingly rapid recovery can also be a warning sign. Many people experience a sense of peace or relief when they fully commit to the idea of suicide. To an outside observer, this may look like improvement. In reality, healing from suicidal ideation is a complex process, and may take a long time. If a person is talking about suicide one day, and seems to be perfectly healthy the next, it may be a serious cause for concern.
In particular, sudden generosity may be a sign that the person is planning to commit suicide6 in the near future. It’s common for people to start giving away their most prized possessions in preparation for the act itself, in the attempt to avoid being a burden on loved ones after they’re gone.
When a person starts talking about specific plans for suicide,7 or starts collecting items that may be used for self harm, you should take emergency action. This may include going out to buy a gun, hoarding prescription medications, or performing internet searches on the subject of self-harm.
Some people plan to commit suicide on a particular date, after a certain milestone is reached, or under other specific circumstances. If someone you believe to be suicidal starts talking about a day after which “they’ll be gone,” you should do your best to get them professional help as soon as possible.
If someone you love is showing any of these warning signs, they may require urgent medical care. Depending on your area, there may be a variety of options available.
If you believe someone is in imminent danger, do not leave them alone. Psychologist Ursula Whiteside explains that even the most intense emotions “usually resolve or become manageable in less than 24 or 48 hours.” Just staying present, either in person or by phone, can significantly lower your loved one’s risk of suicide.8
Don’t be afraid to discuss the issue head-on. Some people are afraid to mention suicide, for fear it can trigger a loved one’s symptoms. However, Doreen Marshall, psychologist and vice president of programs at the American Foundation for Suicide Prevention, says “there’s no research to support that.” Instead, she recommends asking direct questions, like “have you ever had thoughts of suicide?” or “what do you think of people who kill themselves?” These questions can open up a conversation, inviting your loved one to ask for the specific kind of support they need.
If at all possible, try to discourage a person in crisis from using substances. There is a strong link between substance misuse and suicidality,9 and substances may be especially tempting for a person who is used to self-medicating. However, this behavior can destabilize brain chemistry even further, making it hard for a person to safely navigate a crisis.
Although you may be able to sit with someone for a few hours or even a few days, you can’t provide your own loved one with professional mental health care. No matter how well you know them, or how well-trained you are in the field of psychology, the simple fact of your relationship means you cannot be objective. And a person in crisis deserves to receive high quality care.
If the person is not in immediate physical danger, you can take the time to research inpatient programs that treat suicidal clients. You might start by looking for behavioral health providers that are in-network with their insurance. Substance Abuse and Mental Health Services Administration (SAMHSA) also recommends contacting your loved one’s “primary care physician to arrange a mental health screening and evaluation.” In less urgent circumstances, a loved one who is suicidal10 may find this process less jarring than being taken to the emergency room.
If your loved one is in immediate physical danger, you should call emergency services.11 In the U.S., you can dial 911 and explain to the operator what’s happening. They may respond by sending an ambulance or a police officer. In this situation, the police can take a person to the hospital either voluntarily or involuntarily.
You may be in the same room as your loved one, and so able to meet a team of emergency service providers in person. However, if you’re concerned because you can’t reach a loved one, you can also call and ask for a wellness check. In this case, you should “call the non-emergency number for the police department in your community and explain why you are concerned.” When you explain the situation, they may be able to visit your loved one and check on them even if you’re not physically present.
In an emergency situation, it’s important to act quickly. But don’t assume that the situation will immediately be resolved. Short-term care is just the beginning of a much longer healing process. And for some clients, it’s best to attend rehab to treat suicidality.
Not every rehab facility is equipped to treat people with these symptoms. Clients with suicidal ideation may need specialized care. If your loved one is considering inpatient treatment, make sure to ask the admissions team which of the following amenities they offer:
During a suicidal crisis, clients often require round-the-clock care. This high level of supervision is a temporary emergency measure, and not a long-term solution. Certain rehab facilities offer constant monitoring to prevent clients from inflicting self-harm.
In a facility with anti-ligature protocols, providers take special care to keep clients from accessing items that might cause them harm. Specifically, an anti-ligature fixture is designed in such a way that clients cannot attach any other objects to it. Facilities with these protocols might also ask residents to surrender their shoelaces, or prohibit them from using knives during meals.
During and immediately after a crisis, some clients may benefit from pharmaceutical treatment. Specifically, doctors may administer ketamine12 or benzodiazepines13 (such as xanax) to interrupt urgent suicidal ideation. These treatments are not appropriate for all clients, nor are they long-term solutions. They’re simply a way to temporarily relieve symptoms, giving you, your loved one, and their medical team the time to plan for longer-term care.
Suicidal ideation is extremely serious. However, it doesn’t have to result in an emergency. If you can recognize the warning signs, you may be able to get your loved one help before they attempt self-harm.
Whenever you take action, make sure to respond with an appropriate level of urgency. In some cases, it’s appropriate to admit the person to a hospital immediately. In other situations, it may be even more beneficial to simply help them find a therapist.
Remember that you, too, have limits. There’s only so much that any one person can do to help someone in a the midst of a suicidal crisis. And that’s why it’s so important to seek out professional help.
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